Provider Demographics
NPI:1598194599
Name:BITTER, KIMBERLY (CNM)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:BITTER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 NORTHSIDE FORSYTH DR
Mailing Address - Street 2:STE 350
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-8447
Mailing Address - Country:US
Mailing Address - Phone:770-886-3555
Mailing Address - Fax:
Practice Address - Street 1:1800 NORTHSIDE FORSYTH DR
Practice Address - Street 2:STE 350
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041-8447
Practice Address - Country:US
Practice Address - Phone:770-886-3555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-11
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN236367367A00000X
CO367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003143839AMedicaid